BMI In Young Children...Kind Of A Vent/Request For Info? I Guess?

[SilverSabre25]

Just out of curiosity, is Mom is over-weight?

No, not exactly. She's not a stick like dcd is, but she's definitely not "fat". I'd say she's about average.

[jen]

No, not exactly. She's not a stick like dcd is, but she's definitely not "fat". I'd say she's about average.

Ah, I thought maybe doc was making assumptions based on Mom's weight.

[PeanutsGalore]

Let's see...take him off whole milk and put him on skim, quit giving him juice, no more fries and chicken nuggets, no more candy and soda...

Wanna know the kicker?

He doesn't eat that stuff.

We serve water 99% of the time here. We don't serve fried foods at daycare and he doesn't get them at home either. They don't eat out. He gets primarily water at home, too. There aren't tons of sweets either place.

part of dcm's flipping out while she was talking to me was that she can't think where to "improve" his diet, because it doesn't contain any of that stuff with anything that even vaguely could be called regularity.

This is why I responded to you the way I did. You aren't serving him junk, his mom isn't serving him junk, and he's not really overweight. He's also active. You don't actually need to make any changes, nor does his mom.

A doctor has a responsibility, IMO, to get to know the patient and find out what the lifestyle is at home, especially if that patient is going to be under their care for another few years. Only after getting to know a patient and KNOWING that the diet is cr*p and there is a very low level of activity should it be "discussed". Otherwise, it's not courage to bring the topic up and make a parent feel guilty about their NOT overweight, active child who eats healthy. It's something else.

I'm not taking up for any parent who chooses to feed their kid a junk food diet (a whole bag of marshmallows? Really? Diabetes, here we come!). I just think that if we read the original post in this situation, the obesity epidemic topic really doesn't apply. What we have is a mom who is now concerned about something she should not be concerned with, and the impact may be that she holds a tighter reign over what her kid is eating, and THAT can backfire and actually cause...well, obesity. And I think it's the doctor's fault, because, for whatever reason, he harassed her about something during a doctor's visit that he should not have.

Silver, thank you for encouraging the mom not to get too crazy over this. I'm sure that you and she will keep a proper eye out on the kid's diet and make sure he gets lots of exercise!

ETA: and I was actually serious about her changing docs. If she can't have a simple discussion with him and shut down the harassment by letting him know that her kid DOES eat a healthy diet, then she needs a doctor with whom she can feel free to talk. I let my doctors know upfront what my kid's diet is, and it makes them deal with me in a different way because they know I'm already informed.

[nannyde]

This is why I responded to you the way I did. You aren't serving him junk, his mom isn't serving him junk, and he's not really overweight. He's also active. You don't actually need to make any changes, nor does his mom.

A doctor has a responsibility, IMO, to get to know the patient and find out what the lifestyle is at home, especially if that patient is going to be under their care for another few years. Only after getting to know a patient and KNOWING that the diet is cr*p and there is a very low level of activity should it be "discussed". Otherwise, it's not courage to bring the topic up and make a parent feel guilty about their NOT overweight, active child who eats healthy. It's something else.

I'm not taking up for any parent who chooses to feed their kid a junk food diet (a whole bag of marshmallows? Really? Diabetes, here we come!). I just think that if we read the original post in this situation, the obesity epidemic topic really doesn't apply. What we have is a mom who is now concerned about something she should not be concerned with, and the impact may be that she holds a tighter reign over what her kid is eating, and THAT can backfire and actually cause...well, obesity. And I think it's the doctor's fault, because, for whatever reason, he harassed her about something during a doctor's visit that he should not have.

Silver, thank you for encouraging the mom not to get too crazy over this. I'm sure that you and she will keep a proper eye out on the kid's diet and make sure he gets lots of exercise!

I don't agree with this at all.

I don't think it's the doctors business to get to know the family. I think it's their business to DO a well child visit when he's being paid to do a well child visit. If the numbers don't add up they don't add up.

Take it from someone who HAS had the discussion with parents about their kids weight... they don't take it well at ALL and they only hear one thing: you are saying something bad about my kid... you are saying my kid is fat.

Doesn't matter if they spent the time or not going thru his diet/exercise/sleep... in the end... when she walks out the door she's thinking the same thing she thought when they brought it up in the office.

Telling a parent the numbers isn't harrassment. It's the first step in "let's keep an eye on this". They could have said "oh his development is most excellent... his physical is perfect with heart, lung, skeletal.... the only concern we have... and it's just a concern that we must keep our eyes on... his BMI is too high... we know that kids who have THIS BMI at this age have an X percent chance of being obese at X age and into adulthood....

Even if they did THAT level of education along side of the compliment sandwhich... the parent is STILL going to walk out the door going "he said my kid was fat".

Family docs will be doing this at well child visits because there is a HUGE market now for dealing with obesity in kids. They just have to figure out how to get paid for it.